Kuvunika kw'ijosi ry'ingore ni imvune ikunze kugaragara kandi ishobora gutera ubwoba ku baganga b'amagufwa, bitewe n'amaraso adakora neza, kugabanuka kw'ivunika ry'ingore no kurwara osteonecrosis biri hejuru, uburyo bwiza bwo kuvura ivunika ry'ijosi ry'ingore buracyari impaka, abahanga benshi bemeza ko abarwayi barengeje imyaka 65 bashobora kwitabwaho mu bijyanye no gutera imiti, kandi abarwayi bari munsi y'imyaka 65 bashobora gutoranywa mu kubagwa imbere, kandi ingaruka zikomeye ku gutembera kw'amaraso ziterwa no kuvunika kw'ijosi ry'ingore ry'ingore. Kuvunika kw'ijosi ry'ingore ry'ingore ry'ingore rigira ingaruka zikomeye cyane ku maraso, kandi kugabanya no gufunga imbere ni bwo buryo busanzwe bwo kuvura ivunika ry'ijosi ry'ingore ry'ingore. Kugabanya neza bifasha mu gutuma ivunika rihagarara, bigatera imbere gukira kw'ivunika no gukumira ikwirakwira ry'ivunika ry'ingore ry'ingore.
Ibi bikurikira ni urugero rusanzwe rw'ivunika ry'umutwe w'ijosi ry'ijosi kugira ngo tuganire ku buryo bwo gukora uburyo bwo gufunga imbere hifashishijwe vis ifite kannule.
Ⅰ Amakuru y'ibanze ku rubanza
Amakuru y'umurwayi: umugabo w'imyaka 45
Ikirego: kubabara mu kibuno cy'ibumoso no kugabanya gukora amasaha 6.
Amateka: Umurwayi yaguye ubwo yari arimo koga, atera ububabare mu kibuno cy'ibumoso n'intege nke z'imikorere, ibyo bikaba bitashoboraga koroherwa no kuruhuka, maze yinjira mu bitaro byacu afite ikibazo cyo kuvunika ijosi ry'ijosi ry'ibumoso kuri radiyo, maze yinjira mu bitaro afite umutima mwiza n'umwuka mubi, yinubira ububabare mu kibuno cy'ibumoso n'intege nke z'imikorere, kandi ntarye kandi ntakongere kwituma amara ye ya kabiri nyuma y'imvune.
Ⅱ Isuzuma ry'umubiri (Isuzuma ry'umubiri wose n'isuzuma ry'inzobere)
T 36.8°C P87 bets/min R20 bets/min BP135/85mmHg
Imikurire isanzwe, imirire myiza, imiterere idahindagurika, imitekerereze isobanutse, ubufatanye mu gusuzuma. Ibara ry'uruhu ni risanzwe, rirahindagurika, nta kubyimba cyangwa uduheri, nta kwiyongera kw'uturemangingo tw'umubiri wose cyangwa mu gace k'aho utuye. Ingano y'umutwe, imiterere isanzwe, nta bubabare bw'umuvuduko, uburemere, umusatsi urabagirana. Impande zombi zingana mu bunini no mu ruziga, zifite urumuri rworoheje. Ijosi ryari ryoroshye, trachea yari iherereye hagati, tiroyide ntiyagutse, igituza cyari gihagaze neza, guhumeka byari bigufi gato, nta kibazo cyabayeho ku mutima w'ibihaha, imbibi z'umutima zari zisanzwe iyo umuntu akubita, umutima wateraga ibitero 87 ku munota, umutima wateraga Qi, inda yari igororotse kandi yoroshye, nta bubabare bw'umuvuduko cyangwa ububabare bwo gusubira inyuma. Umwijima n'umwobo ntibyagaragaye, kandi nta burwayi bwari mu mpyiko. Impande z'imbere n'inyuma ntizasuzumwe, kandi nta busembwa bw'umugongo, amaguru yo hejuru n'amaguru yo hepfo y'iburyo, hamwe n'ingendo zisanzwe. Impungenge z'umubiri zagaragaye mu gusuzuma ubwonko kandi ntabwo zagaragaye.
Nta kubyimba kw'ikibuno cy'ibumoso kwagaragaye, ububabare bw'umuvuduko bwagaragaye hagati mu kibuno cy'ibumoso, ubumuga bwo kuzenguruka inyuma kw'ikirenge cy'ibumoso, ububabare bw'umurongo wo hasi w'ibumoso (+), imikorere mibi y'ikirenge cy'ibumoso, ibyiyumvo n'imikorere y'amano atanu y'ikirenge cy'ibumoso byari bimeze neza, kandi umuvuduko w'imitsi yo mu kirenge wari usanzwe.
Ⅲ Ibizamini by'inyongera
Filimi ya X-ray yagaragaje: kuvunika kw'ijosi ry'ibumoso ry'ijosi ry'inyuma, gucika kw'inyuma yavunitse.
Ibindi byakozwe mu gusuzuma biochemical, X-ray yo mu gituza, densitometry y'amagufwa, na ultrasound y'amabara y'imitsi yo hasi yo hasi ntabwo byagaragaje ikibazo na kimwe kigaragara.
Ⅳ Gusuzuma no gusuzuma indwara zitandukanye
Dukurikije amateka y'umurwayi yahuye n'ihungabana, ububabare bw'ikibuno cy'ibumoso, imbogamizi ku bikorwa bye, gusuzuma umubiri w'ikirenge cy'ibumoso cyo hasi no kugabanya imiterere y'inyuma, ububabare bw'ikibuno bugaragara, ububabare bw'ikirenge cy'ibumoso mu gice cyo hasi cyo hepfo (+), imikorere mibi y'ikibuno cy'ibumoso, hamwe na X-ray film, bishobora kumenyekana neza. Gucika kw'ikibuno cya trochanter bishobora kandi kugira ububabare bw'ikibuno no kugabanya imikorere y'ikibuno, ariko ubusanzwe kubyimba kwaho biragaragara, aho igitutu kiri muri trochanter, kandi inguni yo kuzenguruka inyuma ni nini, bityo bishobora gutandukana na yo.
Ⅴ Ubuvuzi
Hakozwe isuzuma ryuzuye ryo kugabanya inzara no kuziba imbere mu nzara.
Filimi mbere yo kubagwa ni iyi ikurikira
Gukora imyitozo ngororamubiri hifashishijwe uburyo bwo kuzunguruka imbere no gukurura urugingo rwangiritse, hanyuma agafata gato urugingo rwangiritse nyuma yo kugarura uruhu no gupima uruhu, byagaragaje ko byakize neza.
Agashishwa ka Kirschner kashyizwe ku buso bw'umubiri mu cyerekezo cy'ijosi ry'abagore kugira ngo gakoreshwe mu gupima uruhu, hanyuma hagakorwa agashishwa gato k'uruhu hakurikijwe aho agashishwa gaherereye.
Agapira k'ingofero gashyirwa mu ijosi ry'ingofero gahuye n'ubuso bw'umubiri mu cyerekezo cy'agapira ka Kirschner mu gihe gahora gahengamye imbere ya dogere zigera kuri 15 hanyuma hagakorwa fluoroscopy
Agapira ka kabiri k’ubuyobozi gashyirwamo binyuze mu gice cy’imbere cy’inyuma hakoreshejwe agapira kari iruhande rw’inyuma rw’icyerekezo cy’agapira ka mbere k’ubuyobozi.
Urushinge rwa gatatu rushyirwa inyuma y'urushinge rwa mbere binyuze mu buyobozi.
Hakoreshejwe ishusho ya fluoroscopic y'igikeri, udupira twose twa Kirschner twagaragaye ko turi mu ijosi ry'ijosi ry'abagore.
Dobora imyobo mu cyerekezo cy'agapira k'indorerwamo, upime uburebure hanyuma uhitemo uburebure bukwiye bw'umusumari w'ubudodo upfundikiye ku gapira k'indorerwamo, ni byiza kubanza gupfuka umugongo w'imboro w'umusumari w'ubudodo, bishobora gukumira gutakaza uburyo bwo kuwusubiza inyuma.
Shyira izindi screw ebyiri zirimo uduce duto, imwe nyuma y'indi, hanyuma urebe muri
Indwara yo gukata uruhu
Filime yo gusuzuma nyuma yo kubagwa
Hamwe n'imyaka y'umurwayi, ubwoko bw'imvune, n'ubwiza bw'amagufwa ye, ni byo byakunzwe cyane mu gufata inzara zifunze, zifite ibyiza byo gukomereka guke, ubushobozi bwo kuzifata neza, gukora byoroshye kandi byoroshye kuzimenya, zishobora gukandamizwa hakoreshejwe imbaraga, imiterere y'ubuhumekero ituma umuntu atakaza ubuhumekero mu mutwe, kandi imvune ikira cyane.
Incamake
1 Gushyira inshinge za Kirschner ku buso bw'umubiri hakoreshejwe fluoroscopy ni byiza mu kumenya aho urushinge rushyirwa n'icyerekezo ndetse n'urwego rw'aho uruhu rucibwa;
2 Udupira dutatu twa Kirschner tugomba kuba dufatanye, duhindagurika, kandi hafi y'inkombe uko bishoboka kose, ibyo bikaba byorohereza gutuza no gukandagira nyuma;
3 Aho pin ya Kirschner yo hasi igomba gutoranywa ku gice cy’imbere cy’ijosi ry’ijosi kigaragara cyane kugira ngo harebwe ko pin iri hagati mu ijosi ry’ijosi, mu gihe impera z’ipin ebyiri zo hejuru zishobora gutembera imbere no inyuma ku gice cy’imbere cy’ijosi kigaragara cyane kugira ngo byorohe gufata;
4 Ntugashyire agapira ka Kirschner mu bujyakuzimu cyane icyarimwe kugira ngo wirinde kwinjira mu gice cy'imbere cy'umugongo, agace k'umugongo gashobora gutoborwa mu murongo w'aho imvune iherereye, kimwe ni ukurinda gutoborwa mu mutwe w'inkende, ikindi kikaba gifasha mu gukanda inzara z'umugongo;
5 Udupira tw’ubudodo dushyizwemo hafi hanyuma tukanyuramo gato, reba uburebure bw’udupira tw’ubudodo ari bwo bwiza, niba uburebure butari kure cyane, gerageza kwirinda gusimbuza kenshi udupira, niba osteoporosis, gusimbuza udupira biba ari ugufata udupira tw’ubudodo mu buryo budafite akamaro, kugira ngo umurwayi amenye neza ko udupira tw’ubudodo tuzafata neza, ariko uburebure bw’udupira ni bubi gato kuruta uburebure bwo gufata udupira tw’ubudodo mu buryo budafite akamaro ni bwiza cyane!
Igihe cyo kohereza: Mutarama 15-2024
